Small Fiber Neuropathy is often an undiagnosed disease and the only way to DEFINITIVELY diagnose it is by taking a skin biopsy and performing Epidermal Nerve Fiber Density (ENFD) testing. Diagnosis can be extremely helpful in determining which treatment option is best for a particular patient. Early detection can also be important as detection of reduced small nerve fiber density can predict the progression to a larger-spread neuropathy. An ENFD test can reduce overall healthcare costs, unnecessary surgeries, unnecessary treatments and improve patient care. Once diagnosed and treated, ENFD testing can be utilized to evaluate the course of treatment for patient improvement, and can be adjusted accordingly if necessary. Standard tests for nerve damage such as electromyograms and nerve conduction studies (EMG and NCS) are gross measures of large nerves, but they cannot give the appropriate information on the health of small sensory nerve fibers.